The Primary purpose of this research proposal is to conduct an extensive evaluation of the potential costs and savings associated with the implementation of an Electronic Medical Record. The objectives of this project are as follows: to demonstrate how an EMR can lead to improvements in effective and efficient patient care; to identify opportunities to improve health care quality, cost, and access through the use of information technology; to identify documentation requirements for implementation and development of an EMR; to identify opportunities to eliminate redundancy, fragmentation, and duplication of services; to identify hardware and software technologies that will assist Baylor College of Medicine's Information Technology Department to identify and implement an EMR. An objective based approach will be used to evaluate the current medical record practices(systems) and their impact on users, patients, and the BCM environment. A Benefit analysis will be conducted to determine cost savings, operational benefits, and intangible benefits associated with the development and implementation of an EMR. The current medical record will be evaluated to determine its strengths, weaknesses, opportunities and threats. Data collection methods will include observation, interviews, document analysis, clinical chart reviews, questionnaires, and or simulated patients. Surveys of and or focused interviews with physicians and the clinic staff will be used to determine their satisfaction with the current system, their ideas, their needs, how they would like to use computers in their practice, the type of computer training they would like and their satisfaction with the transcription and other systems.